This is an application for the tuberculosis Academic Award. The overall objective is to develop an independent career in tuberculosis (TB) education, research, and control. The applicant is an internist board certified in infectious diseases. She is an assistant professor of medicine, and director of the medicine core-clerkship at Case Western Reserve University School of Medicine. This proposal is designed to develop and evaluate educational programs to prepare medical caregivers to effectively deal with TB in the 21st century. The major emphasis of this proposal includes epidemiology with specific attention to changes resulting from the AIDS epidemic, host-parasite relationship, clinical spectrum, and aspects of disease prevention. The specific aims of this proposal are: 1) to develop, implement, and evaluate a coordinated curriculum with varied learning venues throughout the four years of medical school, 2) to effect and assess a defined, organized curriculum to extend throughout the three years of housestaff training, 3) to enhance TB awareness (with particular emphasis on the importance of prevention) in care providers of a high risk inner city African American population, 4) to update practicing physicians on relevant aspects of TB prevention, management, and control. To achieve the specific aims, each student and resident will encounter case material of sufficient variety, computer case simulations and case-oriented group tutorial sessions are emphasized. Additionally, educational interventions which include group sessions as well as computer case simulations are also proposed for primary caregivers in the inner city (whose population has the highest rate of TB in Cleveland). To evaluate the educational interventions, the following endpoints will be used: 1) proficiency scores from computer-based patient management problems, 2) performance scores reflecting the student's ability to elicit a focused history and perform a focused physical examination as assessed by the objective structured clinical examination, 3) medical student performance scores of knowledge base assessment, 4) the percentage of patients appropriately screened for TB in both neighborhood inner city clinics and Medical Residents' clinic, 5) structured questionnaires and interviews to assess satisfaction with the program, and 6) a structured instrument to assess attitudes toward TB prevention.